A population-based study on tetanus antitoxin levels in the Netherlands

Melker, Hester E. de; Hof, Susan van den; Berbers, Guy A. M.; Nagelkerke, Nicolaas; Rümke, H C; Spaendonck, M. A. E. Conyn-Van

doi:10.1016/s0264-410x(99)00186-3

Cited by 32 publications

(20 citation statements)

References 21 publications

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“…Especially relevant are the results of two independent field trials, which revealed a correlation between pertactin antibodies and clinical protection (Cherry & Olin 1999 ;Cherry et al, 1998 ;Storsaeter et al, 1998). Our previous studies have provided indirect epidemiological evidence that variation in pertactin is immunologically relevant and may be linked to the re-emergence of pertussis in vaccinated populations (de Melker et al, 1997 ;Mooi et al, 1998Mooi et al, , 1999Mastrantonio et al, 1999). For example, isolates with vaccine-type pertactin were found in lower frequencies in vaccinated children compared to nonvaccinated children, suggesting that variation in pertactin affects vaccine efficacy (Mooi et al, 1998).…”

Section: Discussionmentioning

confidence: 92%

“…For about 40 years, widespread immunization of young children with whole-cell pertussis vaccines (WCVs) has been successful in controlling the disease. However, in recent years the incidence of pertussis has increased in a number of countries, including Australia, Canada, USA and The Netherlands, despite a high vaccination coverage (Andrews et al, 1997 ;Bass & Stephenson, 1987 ;Bass & Wittler, 1994 ;de Melker et al, 1997 ;DeSerres et al, 1995). We have previously reported that two B. pertussis antigens implicated in protective immunity, pertactin The GenBank accession numbers for the sequences reported in this paper are AJ011015, AJ011016, AJ011091, AJ011092, AJ011093, AJ132095, AJ245927 and X54547.…”

Section: Introductionmentioning

confidence: 99%

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Role of the polymorphic region 1 of the Bordetella pertussis protein pertactin in immunity

et al. 2001

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In several countries pertussis is re-emerging, despite a high vaccination coverage. It is suggested that antigenic divergence between Bordetella pertussis vaccine strains and circulating strains, in particular with respect to pertactin, has contributed to pertussis re-emergence. Polymorphism in pertactin is essentially limited to region 1, which is composed of repeats and is located adjacent to an Arg-Gly-Asp motif implicated in adherence. Evidence is provided for the immunological relevance of polymorphism in region 1. Region 1 was found to contain a B-cell epitope recognized in both humans and mice. Furthermore, variation in region 1 affected antibody binding and, in a mouse respiratory infection model, the efficacy of a whole-cell vaccine. Moreover, passive and active immunization indicated that region 1 confers protective immunity. An mAb directed against a linear conserved epitope conferred crossimmunity against isolates with distinct pertactin variants. The results indicate an important role of region 1 of pertactin in immunity.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Role of the polymorphic region 1 of the Bordetella pertussis protein pertactin in immunity

et al. 2001

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“…In The Netherlands, pertussis is an endemic disease with regular epidemic outbreaks despite the fact that most children have been vaccinated against pertussis since 1953(de Melker et al, 1997, 2000. A remarkable increase in the pertussis incidence has been observed since 1996 (de Melker et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Changes in the Dutch Bordetella pertussis population in the first 20 years after the introduction of whole-cell vaccines

Loo

Mooi

2002

Microbiology

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“…22,74 The length of long-term protection after five or six doses is uncertain, but seems to be at least 20-25 years in populations receiving primary doses in infancy, and boosters in childhood and adolescence. [86][87][88] Recommended vaccination schedules vary by country. WHO recommends that at least five doses of tetanus toxoid vaccine be given over 12-15 years, starting in infancy; a sixth dose given in early adulthood is encouraged, to ensure longlasting protection.…”

Section: Immunologymentioning

confidence: 99%

Maternal and Neonatal Tetanus

Roper

Vandelaer

Gasse

2008

Obstetric Anesthesia Digest

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Maternal and neonatal tetanus are important causes of maternal and neonatal mortality, claiming about 180 000 lives worldwide every year, almost exclusively in developing countries. Although easily prevented by maternal immunisation with tetanus toxoid vaccine, and aseptic obstetric and postnatal umbilical-cord care practices, maternal and neonatal tetanus persist as public-health problems in 48 countries, mainly in Asia and Africa. Survival of tetanus patients has improved substantially for those treated in hospitals with modern intensive-care facilities; however, such facilities are often unavailable where the tetanus burden is highest. The Maternal and Neonatal Tetanus Elimination Initiative assists countries in which maternal and neonatal tetanus has not been eliminated to provide immunisation with tetanus toxoid to women of childbearing age. The ultimate goal of this initiative is the worldwide elimination of maternal and neonatal tetanus. Since tetanus spores cannot be removed from the environment, sustaining elimination will require improvements to presently inadequate immunisation and health-service infrastructures, and universal access to those services. The renewed worldwide commitment to the reduction of maternal and child mortality, if translated into effective action, could help to provide the systemic changes needed for long-term elimination of maternal and neonatal tetanus.Tetanus in the first 28 days of life (neonatal tetanus) was long recognised by clinicians in resource-poor settings as an important cause of neonatal death. However, since babies affected by this disease usually are born at home and die there without registration of either event, the true burden was unknown. In the 1970s and 1980s, community-based surveys about neonatal tetanus from more than 40 countries showed that fewer than 10% of tetanus-related cases and deaths were routinely reported in most countries: in some regions, the reporting fraction was as low as 2-5%. 1,2 Estimates based on the results of these surveys, and tetanus data routinely reported to WHO suggested that, in the 1980s, more than 1 million deaths every year were attributable to tetanus, with an estimated 787 000 deaths in 1988 from neonatal tetanus alone. 1,3 In 1989, the worldwide public-health community made a commitment to the elimination of neonatal tetanus (defined as fewer than one case of neonatal tetanus per 1000 livebirths in all districts) by 1995. 3,4 Maternal tetanus is defined as tetanus during pregnancy, or within 6 weeks of the end of pregnancy (whether pregnancy ended with birth, miscarriage, or abortion), and has the same risk factors and means of prevention as neonatal tetanus. In the early 1990s it was estimated to account for about 5% of maternal mortality, or 15 000-30 000 deaths every year. 5,6 In 1999, the elimination of maternal tetanus was added to the goals of the elimination programme for neonatal tetanus, and the initiative was renamed the Maternal and Neonatal Tetanus Elimination Program. 6 Good progress has been made in the 15 ...

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A population-based study on tetanus antitoxin levels in the Netherlands

Cited by 32 publications

References 21 publications

Role of the polymorphic region 1 of the Bordetella pertussis protein pertactin in immunity

Role of the polymorphic region 1 of the Bordetella pertussis protein pertactin in immunity

Changes in the Dutch Bordetella pertussis population in the first 20 years after the introduction of whole-cell vaccines

Maternal and Neonatal Tetanus

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